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PubMed1993

Osseointegrated implants in microvascular fibula free flap reconstructed mandibles.

In the past, prosthodontic rehabilitation of patients who underwent segmental mandibular resection relied on removable prostheses, which were less than ideal. The advent of the microvascular free flap has provided improved appearance and function through reconstruction of the skeletal integrity of the mandible. In select patients osseointegrated implants strategically placed in the reconstructed mandible can be used to restore masticatory function. Patient selection criteria and techniques are discussed.

Adolescent↗
PubMed2004

Computer aided designed neo-clavicle out of osteotomized free fibula: case report.

Total clavicle reconstruction is a challenging task. We performed a reconstruction of the ventral shoulder girdle by calculating a 3D DICOM representation of the left clavicle to create a right neo-clavicle. Two cuts in correct position and angle leads to a natural 3D shape of the new clavicle. The data were used with a thermo-jet procedure to form model slices of thermoplastic wax. Subsequently, the double titanium osteotomy template with correct cut-angulation was constructed. A 40-year old patient presented with symptoms of progressive pain and instability in the shoulder girdle resulting from complete right clavicle resection due to desmoid tumour 23 years earlier. During the operative procedure, dissection, guided double osteotomy, microvascular anastomoses and acromioclavicular-sternoclavicular fixation were performed. The computer-assisted planning resulted in the exact calculation of the two osteotomy cuts, hence, the 3D appearance of the neo-clavicle. Two years postoperatively, patient showed slightly improved elevation and complete recovery from pain. Our operative procedure demonstrates that the computer-assisted planning with construction of a wax model and an osteotomy template is a useful approach to plan the two precise cuts leading to a predictable shape of the clavicle.

Adult↗